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General NPI Number Information
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NPI Number | 1720654064
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Entity Type | Individual
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Provider Name | PRESTON D'SOUZA MD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 301 UNIVERSITY BLVD
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City | GALVESTON
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State | TX
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Zip | 77555-5302
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Country | US
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Telephone | 409-772-1500
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Fax | 409-772-1742
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Provider Business Mailing Address
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Address Line | 3404 MANDALAY DR
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City | FLOWER MOUND
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State | TX
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Zip | 75022-1021
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Country | US
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Telephone | 316-680-2683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | BP10074410
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License Number State | TX
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